Understanding maternal mortality in women with obesity and the role of care they receive: a national case-control study.
Journal
International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
25
02
2020
accepted:
25
09
2020
revised:
11
09
2020
pubmed:
24
10
2020
medline:
21
12
2021
entrez:
23
10
2020
Statut:
ppublish
Résumé
Obesity has significant implications for the health of pregnant women. However, few studies have quantified its association with maternal mortality or examined the relevant underlying causes and the role of care, although this remains the most severe maternal outcome. Our objectives were to quantify the risk of maternal death by prepregnancy body mass index and to determine whether obesity affected the quality of care of the women who died. This is a national population-based case-control study in France. Cases were 364 maternal deaths from the 2007-2012 National Confidential Enquiry. Controls were 14,681 parturients from the nationally representative 2010 perinatal survey. We studied the association between categories of prepregnancy BMI and maternal death by multivariable logistic regression, estimating adjusted odds ratios and 95% confidence intervals, overall and by specific causes of death. Individual case reviews assessed the quality of care provided to the women who died, by obesity status. Compared with women with normal BMI, underweight women (<18.5 kg/m The risk of maternal death increases with BMI; it multiplied by 1.6 in overweight women and more than tripled in pregnant women with severe obesity. Training clinicians in the specificities of care for pregnant women with obesity could improve their outcomes.
Identifiants
pubmed: 33093597
doi: 10.1038/s41366-020-00691-4
pii: 10.1038/s41366-020-00691-4
pmc: PMC7752756
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
258-265Investigateurs
Dominique Chassard
(D)
Henri Cohen
(H)
Michel Dreyfus
(M)
Jean-Claude Ducloy
(JC)
Irina Guseva-Canu
(I)
Jean-Pierre Laplace
(JP)
Véronique Le Guern
(V)
Sylvie Leroux
(S)
Estelle Morau
(E)
Claire Rondet
(C)
Mathias Rossignol
(M)
Véronique Tessier
(V)
Éric Verspyck
(É)
Philippe Weber
(P)
Laurent Zieleskiewicz
(L)
Commentaires et corrections
Type : CommentIn
Références
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.
doi: 10.1016/S0140-6736(14)60460-8
Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989–2007. Int J Obesity. 2010;34:420–8.
doi: 10.1038/ijo.2009.250
Branum AM, Kirmeyer SE, Gregory EC. Prepregnancy body mass index by maternal characteristics and state: data from the birth certificate, 2014. Natl Vital Stat. 2016;65:1–11.
Deputy NP, Dub B, Sharma AJ. Prevalence and trends in prepregnancy normal weight - 48 States, New York City, and District of Columbia, 2011–2015. MMWR Morbidity and Mortality Weekly Report. 2018;66:1402–7.
doi: 10.15585/mmwr.mm665152a3
Blondel B, Coulm B, Bonnet C, Goffinet F, Le Ray C. National Coordination Group of the National Perinatal STrends in perinatal health in metropolitan France from 1995 to 2016: results from the French National Perinatal Surveys. J Gynecol Obstet Human Reproduct. 2017;46:701–13.
doi: 10.1016/j.jogoh.2017.09.002
O’Brien TE, Ray JG, Chan WS. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14:368–74.
doi: 10.1097/01.EDE.0000059921.71494.D1
Guelinckx I, Devlieger R, Beckers K, Vansant G. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev. 2008;9:140–50.
doi: 10.1111/j.1467-789X.2007.00464.x
Schummers L, Hutcheon JA, Bodnar LM, Lieberman E, Himes KP. Risk of adverse pregnancy outcomes by prepregnancy body mass index: a population-based study to inform prepregnancy weight loss counseling. Obstet Gynecol. 2015;125:133–43.
doi: 10.1097/AOG.0000000000000591
Knight M, Kurinczuk JJ, Spark P, Brocklehurst P. Extreme obesity in pregnancy in the United Kingdom. Obstet Gynecol. 2010;115:989–97.
doi: 10.1097/AOG.0b013e3181da8f09
Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obesity Rev. 2008;9:635–83.
doi: 10.1111/j.1467-789X.2008.00511.x
Lisonkova S, Muraca GM, Potts J, Liauw J, Chan WS, Skoll A, et al. Association between prepregnancy body mass index and severe maternal morbidity. JAMA. 2017;318:1777–86.
doi: 10.1001/jama.2017.16191
Siddiqui A, Azria E, Howell EA, Deneux-Tharaux C, Group ES. Associations between maternal obesity and severe maternal morbidity: findings from the French EPIMOMS population-based study. Paediatr Perinat Epidemiol. 2019;33:7–16.
doi: 10.1111/ppe.12522
Campbell KH, Savitz D, Werner EF, Pettker CM, Goffman D, Chazotte C, et al. Maternal morbidity and risk of death at delivery hospitalization. Obstet Gynecol. 2013;122:627–33.
doi: 10.1097/AOG.0b013e3182a06f4e
Main EK, McCain CL, Morton CH, Holtby S, Lawton ES. Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities. Obstet Gynecol. 2015;125:938–47.
doi: 10.1097/AOG.0000000000000746
Heyl PS, Sappenfield WM, Burch D, Hernandez LE, Kavanaugh VM, Hill WC. Pregnancy-related deaths due to pulmonary embolism: findings from two state-based mortality reviews. Matern Child Health J. 2013;17:1230–5.
doi: 10.1007/s10995-012-1117-5
Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH. Ten years of confidential inquiries into maternal deaths in France, 1998–2007. Obstet Gynecol. 2013;122:752–60.
doi: 10.1097/AOG.0b013e31829fc38c
Deneux-Tharaux C, Saucedo M. Epidemiology of maternal mortality in France, 2010–2012. Gynecol Obstet Fert Senol. 2017;45:S8–21.
Deneux-Tharaux C, Saucedo M. Enhanced system for maternal mortality surveillance in France, context and methods. Gynecol Obstet Fert Senol. 2017;45:S3–7.
Blondel B, Lelong N, Kermarrec M, Goffinet F. Trends in perinatal health in France from 1995 to 2010. Results from the French National Perinatal Surveys. J Gynecol Obstet Biol Reprod. 2012;41:e1–15.
doi: 10.1016/j.jgyn.2012.04.014
Ananth CV, Schisterman EF. Confounding, causality, and confusion: the role of intermediate variables in interpreting observational studies in obstetrics. Am J Obstet Gynecol. 2017;217:167–75.
doi: 10.1016/j.ajog.2017.04.016
White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Stat Med. 2011;30:377–99.
doi: 10.1002/sim.4067
Hernandez LE, Sappenfield WM, Harris K, Burch D, Hill WC, Clark CL, et al. Pregnancy-related deaths, Florida, 1999–2012: opportunities to improve maternal outcomes. Matern Child Health J. 2018;22:204–15.
doi: 10.1007/s10995-017-2392-y
Nair M, Knight M, Kurinczuk JJ. Risk factors and newborn outcomes associated with maternal deaths in the UK from 2009 to 2013: a national case-control study. BJOG. 2016;123:1654–62.
doi: 10.1111/1471-0528.13978
Dowd JB, Zajacova A. Long-term obesity and cardiovascular, inflammatory, and metabolic risk in U.S. adults. Am J Prevent Med. 2014;46:578–84.
doi: 10.1016/j.amepre.2014.01.016
Gregg EW, Cheng YJ, Cadwell BL, Imperatore G, Williams DE, Flegal KM, et al. Secular trends in cardiovascular disease risk factors according to body mass index in US adults. JAMA. 2005;293:1868–74.
doi: 10.1001/jama.293.15.1868
Ortega FB, Lavie CJ. Introduction and update on obesity and cardiovascular diseases 2018. Progr Cardiovasc Dis. 2018;61:87–8.
doi: 10.1016/j.pcad.2018.07.009
Shah R, Gayat E, Januzzi JL Jr., Sato N, Cohen-Solal A, diSomma S, et al. Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox. J Am College Cardiol. 2014;63:778–85.
doi: 10.1016/j.jacc.2013.09.072
Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am College Cardiol. 2014;63:1345–54.
doi: 10.1016/j.jacc.2014.01.022
Hall ME, George EM, Granger JP. The heart during pregnancy. Revista espanola de cardiologia. 2011;64:1045–50.
doi: 10.1016/j.recesp.2011.07.009
Alpert MA, Omran J, Bostick BP. Effects of obesity on cardiovascular hemodynamics, cardiac morphology, and ventricular function. Curr Obesity Reports. 2016;5:424–34.
doi: 10.1007/s13679-016-0235-6
Larsen TB, Sorensen HT, Gislum M, Johnsen SP. Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case-control study. Thrombosis Res. 2007;120:505–9.
doi: 10.1016/j.thromres.2006.12.003
Abdul Sultan A, West J, Tata LJ, Fleming KM, Nelson-Piercy C, Grainge MJ. Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England. BMJ. 2013;347:f6099.
doi: 10.1136/bmj.f6099
Poorolajal J, Jenabi E. The association between body mass index and preeclampsia: a meta-analysis. J Maternal fetal Neonatal Med. 2016;29:3670–6.
doi: 10.3109/14767058.2016.1140738
Denison FC, Aedla NR, Keag O, Hor K, Reynolds RM, Milne A, et al. Care of women with obesity in pregnancy: green-top guideline No. 72. BJOG: Int J Obstet Gynaecol. 2019;126:e62–106.
doi: 10.1111/1471-0528.15386
Seijo M, Minckas N, Cormick G, Comande D, Ciapponi A, BelizAn JM. Comparison of self-reported and directly measured weight and height among women of reproductive age: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2018;97:429–39.
doi: 10.1111/aogs.13326
Platner MH, Ackerman C, Howland RE, Xu X, Pettker CM, Illuzzi JL, et al. Gestational weight gain and severe maternal morbidity at delivery hospitalization. Obstet Gynecol. 2019;133:515–24.
doi: 10.1097/AOG.0000000000003114